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General NPI Number Information
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NPI Number | 1164411278
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Entity Type | Organization
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Legal Business Name | MICHIGAN SURGERY SPECIALISTS P.C.
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 11012 E 13 MILE RD STE 200
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City | WARREN
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State | MI
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Zip | 48093
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Country | US
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Telephone | 586-573-8890
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Fax | 586-573-2706
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Provider Business Mailing Address
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Address Line | 31201 CHICAGO RD S STE C302
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City | WARREN
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State | MI
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Zip | 48093-5553
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Country | US
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Telephone | 586-558-9705
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Fax | 586-558-9706
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MICHELE L KUDLOR
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Credential |
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Telephone | 586-558-9705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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